Osteoarthritis

Definition/Symptoms

Osteoarthritis (OA) is also known as degenerative joint disease. It is the most common type of arthritis. It occurs when the cartilage at the joint surface breaks down and the underlying bone becomes damaged.

Symptoms include pain and stiffness. Crepitus can be present; this is a grating or grinding sensation as the joint moves through its normal range. Swelling may also occur. Symptoms vary from person to person and some people report their symptoms worsen with damp weather and/or activity. These symptoms result in restricted mobility and can lead to the muscles surrounding the joint becoming weaker, reducing the stability of the joint.

OA can be diagnosed by a physical examination. MRI scans or x-rays can also be used to determine the specific degeneration at a joint.

Treatment

Treatment for OA varies depending on the severity of the joint degeneration and the pain this is causing.

Mild OA can be managed with painkillers, physiotherapy, and steroid injections.

Arthroscopic surgery may be indicated to wash out a joint and remove loose fragments of bone which cause a joint to lock.

If a joint is so severely degenerated, joint replacement surgery will be indicated. In the UK, hip and knee replacements are the most common types of joint replacement surgery.

Orthotic Treatment

Orthotic treatment may be used at any stage of osteoarthritic disease.

Foot orthotics are used to provide stability, support and to slow progression of the disease at the bones of the mid and forefoot or ankle. They can also be used to influence the ground reaction forces acting at the knee and hip. This can be an effective treatment in early stages of OA at these joints.

In more severe cases of OA in the foot and ankle, orthotic footwear and insoles can be used to offload painful joints and accommodate severe joint deformity.

Hinged SMOs (supra malleolar orthoses) are lightweight, neat plastic ankle braces. They can be used in severe OA at the ankle where there has been collapse of the joints. These provide stability and relieve pain to allow for continued mobility.

Knee braces can be a very effective way of treating unilateral compartmental OA at the knee. This type of bracing offloads the compartment of the knee that is degenerating, reducing pain and progression of the disease. It is also an alternative treatment in severe OA when surgery is not indicated. Research and development has moved forward in recent years with knee bracing for this condition and it is now recognised as a very effective form of treatment.

Each case of OA presents itself very differently in terms of the symptoms and the biomechanical deficits the joint disease is causing. At LOC, we provide a detailed orthotic assessment and have vast experience in prescribing effective orthotic treatment for this painful condition.

We now have the advantage of using our Gait Lab facilities to test and provide objective measurement of the effectiveness of joint offloading orthotics.